Frequency-Dependent Habituation Deficit of the Nociceptive Blink Reflex in Aura With Migraine Headache. Can Migraine Aura Modulate Trigeminal Excitability?

2017 ◽  
Vol 57 (6) ◽  
pp. 887-898 ◽  
Author(s):  
Armando Perrotta ◽  
Maria Grazia Anastasio ◽  
Roberto De Icco ◽  
Gianluca Coppola ◽  
Anna Ambrosini ◽  
...  
Keyword(s):  
Migraine Headache ◽  
Blink Reflex ◽  
Migraine Aura ◽  
Frequency Dependent ◽  
Nociceptive Blink Reflex

scholarly journals O044. Frequency-dependent habituation deficit of the nociceptive blink reflex in migraine with and without aura

2015 ◽  
Vol 16 (S1) ◽  
Author(s):  
Maria Grazia Anastasio ◽  
Armando Perrotta ◽  
Gianluca Coppola ◽  
Anna Ambrosini ◽  
Giorgio Sandrini ◽  
...  
Keyword(s):  
Blink Reflex ◽  
Frequency Dependent ◽  
Nociceptive Blink Reflex

scholarly journals O043. Frequency-dependent habituation deficit of the nociceptive blink reflex in cluster headache and paroxysmal hemicrania

2015 ◽  
Vol 16 (S1) ◽  
Author(s):  
Armando Perrotta ◽  
Maria Grazia Anastasio ◽  
Gianluca Coppola ◽  
Anna Ambrosini ◽  
Roberto De Icco ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Blink Reflex ◽  
Paroxysmal Hemicrania ◽  
Frequency Dependent ◽  
Nociceptive Blink Reflex

Abnormal Habituation of ‘nociceptive’ Blink Reflex in Migraine-Evidence for Increased Excitability of Trigeminal Nociception

Cephalalgia ◽  
2003 ◽  
Vol 23 (8) ◽  
pp. 814-819 ◽  
Author(s):  
Z Katsarava ◽  
N Giffin ◽  
H-C Diener ◽  
H Kaube
Keyword(s):  
Migraine Attack ◽  
Healthy Subjects ◽  
Migraine Headache ◽  
Regression Coefficient ◽  
Blink Reflex ◽  
Trigeminal Nociception ◽  
Nociceptive Blink Reflex ◽  
Nociceptive Processing ◽  
The Mean ◽  
Stimulation Of

We studied the habituation of the ‘nociceptive’ blink reflex (nBR) in 15 healthy subjects and 17 migraine patients interictally as well as during unilateral migraine headache within six hours of onset and after treatment. In healthy volunteers the mean regression coefficient (MRC) was – 3.9 following right sided and – 4.9 left sided stimulation. This equals an amplitude loss of 19.5% (5 X −3.9) and 24.5% (5 X −4.9), respectively, across five consecutive sweeps. An augmentation of nBR responses was found in migraine patients interictally: MRC = 3.3 following stimulation of the headache side (HA) and MRC = 4.0 of the non-headache side (non-HA). The differences were statistically significant (ANOVA: d.f. = 1, F = 25.8, P < 0.001). During the migraine attack MRCs were negative both before (−5.0, HA and – 4.0, non-HA) and after treatment (−2.6, HA and −1.9 non-HA) and significantly differed from those outside the migraine attack (ANOVA: d.f. = 2, F = 12.4, P < 0.001). The demonstrated lack of habituation of the nBR responses indicates an abnormal trigeminal nociceptive processing in migraine patients outside the migraine attack.

scholarly journals Preventive Treatment With CGRP Monoclonal Antibodies Restores Brain Stem Habituation Deficits and Excitability to Painful Stimuli in Migraineurs: Results From a Prospective Case-control Study

2021 ◽  
Author(s):  
Anne Thiele ◽  
Lara Klehr ◽  
Sebastian Strauß ◽  
Anselm Angermaier ◽  
Ulf Schminke ◽  
...  
Keyword(s):  
Disease Activity ◽  
Brain Stem ◽  
Substantial Reduction ◽  
Preventive Treatment ◽  
Blink Reflex ◽  
Peptide Ligand ◽  
Headache Frequency ◽  
Global Test ◽  
Nociceptive Blink Reflex ◽  
Disease Modifying

Abstract Background & ObjectivesCalcitonin gene-related peptide ligand/receptor (CGRP) antibodies effectively reduce headache frequency in migraineurs. It is understood that they act peripherally, which raises the question whether treatment merely interferes with the last stage of headache generation or, alternatively, causes secondary adaptations in the central nervous system and might thus possess disease modifying potential. This study addresses this question by investigating the nociceptive blink reflex (NBR), which is closely tied to central disease activity, before and after treatment with CGRP antibodies.MethodsWe enrolled 22 episodic migraineurs (21 female, 46.2 ± 13.8 years of age) and 22 age-/gender-matched controls. Patients received assessments of the NBR (R2 component, 10 trials, 6 stimuli/trial) before (V0) and three months (V3) after treatment with CGRP antibodies started, controls were assessed once. The R2 area (R2a) and habituation (R2h; gradient of R2a against stimulus order) of the stimulated/non-stimulated side (_s/_ns) following repeated supraorbital stimulation provide a direct readout of brainstem excitability and habituation as key mechanisms in migraine.ResultsAll patients showed a substantial reduction of headache days/month (V0: 12.4±3.3, V3: 6.6 ± 4.9). R2a_s (Fglobal=5.86, p<0.001; block 1: R2a_s: -28%, p<0.001) and R2a_ns (Fglobal=8.22, p<0.001, block 1: R2a_ns: -22%, p=0.003) were significantly decreased, and R2h_ns was significantly enhanced (Fglobal=3.07, p<0.001; block 6: R2h_ns: r=-1.36, p=0.007) from V0 to V3. The global test for changes of R2h_s was non-significant (Fglobal=1.46, p=0.095). Changes of R2h significantly correlated with improvement of headache frequency (R2h_s, r=0.56, p=0.010; R2h_ns: r=0.45, p=0.045). None of the NBR parameters assessed at baseline predicted treatment response.DiscussionWe provide evidence that three months of treatment with CGRP antibodies restores brain stem responses to painful stimuli and thus might be considered disease modifying. The nociceptive blink reflex may provide a biomarker to monitor central disease activity. Future studies should evaluate the blink reflex as a clinical biomarker to predict treatment response at baseline and to establish the risk of relapse after treatment discontinuation.Trial registrationThis trial was prospectively registered at clinicaltrials.gov (ID: NCT04019496, date of registration: July 15, 2019).

Migraine and Antiphospholipid Antibodies

Cephalalgia ◽  
1992 ◽  
Vol 12 (2) ◽  
pp. 69-74 ◽  
Author(s):  
Gretchen E Tietjen
Keyword(s):  
Antiphospholipid Antibodies ◽  
Migraine Headache ◽  
Migraine Aura ◽  
Neurologic Symptoms ◽  
Actual Role

Migraine and antiphospholipid antibodies. Cephalalgia 1992:12:69–74. Antiphospholipid antibodies have been detected in patients with transient neurologic symptoms including migraine aura. The role of these antibodies in the pathogenesis of migraine is not fully understood. The available data suggest an association between the migraine-like phenomena and antiphospholipid antibodies, but not between migraine headache and antiphospholipid antibodies. To elucidate the actual role of antiphospholipid antibodies in migraine, prospective, controlled studies are needed.

Sumatriptan and Corneal Reflexes in Headache-Free Migraine Patients: A Randomized and Placebo-Controlled Crossover Study

Cephalalgia ◽  
2007 ◽  
Vol 27 (2) ◽  
pp. 165-172 ◽  
Author(s):  
V Busch ◽  
S Kaube ◽  
W Schulte-Mattler ◽  
H Kaube ◽  
A May
Keyword(s):  
Oral Administration ◽  
Crossover Study ◽  
Blink Reflex ◽  
Trigeminal System ◽  
Healthy Controls ◽  
Free Interval ◽  
Nociceptive Blink Reflex ◽  
Before And After ◽  
Corneal Reflex ◽  
Baseline Response

A temporary sensitization of central trigeminal neurones in migraine patients during acute attacks has been described in previous studies using the electrically evoked nociceptive blink reflex. The cornea is innervated by small myelinated A-delta and unmyelinated C-fibres only. Stimulation with air puffs activates peripheral nociceptors and allows the investigation of peripheral trigeminal nerve structures. Our objective was to investigate whether corneal reflex examinations with air puff stimulation detect abnormalities in migraineurs during their pain-free interval and if the corneal reflex may be modulated by the administration of an oral triptan. After validation of the nociceptive air puff technique by investigating the corneal reflexes before and after a local anaesthesia of the cornea, we recorded corneal reflexes in 25 migraineurs during their pain-free period and 25 healthy controls before and after the oral administration of 100 mg sumatriptan in a randomized, placebo-controlled, crossover study. Baseline response areas under the curve (AUCs) and latencies of the R2 components of the corneal reflexes did not show any significant differences between patients and controls. Patients did not show any significant differences regarding their headache and non-headache side. The use of an oral triptan had no significant influence on latencies or AUCs in both patients and controls. Our data suggest that there is no facilitation of the trigeminal system in the headache-free interval among patients with migraine. The stable corneal reflexes after the oral administration of 100 mg sumatriptan suggest that there was no inhibition of the trigeminal system, both in patients during their headache-free period and in healthy controls.

scholarly journals Dietary patterns according to headache and migraine status: A cross-sectional study

Cephalalgia ◽  
2014 ◽  
Vol 35 (9) ◽  
pp. 767-775 ◽  
Author(s):  
Pamela M Rist ◽  
Julie E Buring ◽  
Tobias Kurth
Keyword(s):  
Migraine Headache ◽  
Cross Sectional Study ◽  
Health Study ◽  
Migraine Aura ◽  
Sectional Study ◽  
Attack Frequency ◽  
Cross Sectional ◽  
Processed Meats ◽  
Total Alcohol ◽  
History Of

Background Several potential dietary trigger factors for migraine have been proposed. However, few studies have examined the intake pattern of these dietary items compared to adequate control populations and whether intake levels may vary by migraine aura status or attack frequency. Methods We conducted a cross-sectional study among participants in the Women’s Health Study. We used logistic regression to evaluate the association between migraine and headache status and low intake of foods commonly reported to affect migraine. Results A total of 25,755 women reported no history of migraine or headache, 5573 reported non-migraine headache and 7042 reported any migraine. Those with non-migraine headache or any migraine were more likely to have low intake of total alcohol (OR = 1.22, 95% CI:1.14–1.29 and OR = 1.17, 95% CI:1.11–1.24, respectively). Migraineurs with aura were more likely to have low intake of chocolate, ice cream, hot dogs, and processed meats. Those who experience migraine at least once per week were more likely to have low intake of skim/low-fat milk and white and red wine. Conclusion Intake of most suggested migraine dietary triggers differs by migraine aura status and attack frequency, a pattern not found for non-migraine headache.

Differences of Anti-Nociceptive Mechanisms of Migraine Drugs on the Trigeminal Pain Processing during and Outside Acute Migraine Attacks

Cephalalgia ◽  
2004 ◽  
Vol 24 (8) ◽  
pp. 657-662 ◽  
Author(s):  
Z Katsarava ◽  
V Limmroth ◽  
O Baykal ◽  
D Akguen ◽  
H-C Diener ◽  
...  
Keyword(s):  
Migraine Attack ◽  
Healthy Subjects ◽  
Blink Reflex ◽  
Acute Attack ◽  
Pain Processing ◽  
Acute Migraine ◽  
Double Blind ◽  
Nociceptive Blink Reflex ◽  
Nociceptive Processing ◽  
Acute Migraine Attack

The aim of this study was to investigate central anti-nociceptive mechanisms of i.v. acetylsalicylic acid (ASA) and oral zolmitriptan (ZOL) in migraine patients and healthy subjects using the ‘nociceptive’ blink reflex (nBR). Twenty-eight migraine patients received ASA ( n = 14, 1000 mg i.v) or ZOL ( n = 14, 5 mg p.o) during the acute migraine attack and interictally. Thirty healthy subjects received either ASA or ZOL vs. placebo using a double blind cross over design. nBR was recorded in all patients and subjects before, 60 and 90 min after treatment. ASA and ZOL did not inhibit nBR responses in healthy subjects. Both ASA and ZOL suppressed nBR responses (ASA by 68%, ZOL by 78%) only during the acute attack but not interictally. The data suggest, that the anti-nociceptive effects of migraine drugs on the trigeminal nociceptive processing are different during and outside an acute migraine attack.

scholarly journals Interictal habituation deficit of the nociceptive blink reflex: an endophenotypic marker for presymptomatic migraine?

Brain ◽  
2007 ◽  
Vol 130 (3) ◽  
pp. 765-770 ◽  
Author(s):  
L. Di Clemente ◽  
G. Coppola ◽  
D. Magis ◽  
A. Fumal ◽  
V. De Pasqua ◽  
...  
Keyword(s):  
Blink Reflex ◽  
Nociceptive Blink Reflex

scholarly journals Effects of Visual Cortex Activation on the Nociceptive Blink Reflex in Healthy Subjects

PLoS ONE ◽  
2014 ◽  
Vol 9 (6) ◽  
pp. e100198 ◽  
Author(s):  
Simona L. Sava ◽  
Victor de Pasqua ◽  
Delphine Magis ◽  
Jean Schoenen
Keyword(s):  
Visual Cortex ◽  
Healthy Subjects ◽  
Blink Reflex ◽  
Nociceptive Blink Reflex
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